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International Journal of Implant Dentistry

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Open Access 01-12-2016 | Review

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Authors: Christian Walter, Bilal Al-Nawas, Tim Wolff, Eik Schiegnitz, Knut A. Grötz

Published in: International Journal of Implant Dentistry | Issue 1/2016

Abstract

Objective

Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.

Methods

The PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.

Results

There is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.

Conclusion

Successful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.

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Title: Dental implants in patients treated with antiresorptive medication – a systematic literature review
Authors: Christian Walter
Bilal Al-Nawas
Tim Wolff
Eik Schiegnitz
Knut A. Grötz
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Implant Dentistry / Issue 1/2016
Electronic ISSN: 2198-4034
DOI: https://doi.org/10.1186/s40729-016-0041-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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